Thursday, July 30, 2009
The Huffington Post is crazy about your health
Why bogus treatments and crackpot medical theories dominate "The Internet Newspaper"
By Rahul K. Parikh, M.D.
July 30, 2009 | This spring, during the swine flu outbreak, I was searching the Web for news when a blog post on the Huffington Post caught my eye. Titled "Swine Flu: Protect Yourself and Your Loved Ones," its author, Kim Evans, offered a unique prescription for swine flu, one she believed could "save your life": deep-cleansing enemas.
"Most estimates are that the average person has ten or more pounds of stored waste just in their colon," Evans wrote. "In any case, many people have found that disease disappears when this waste is gone, and that when the body is clean it's much more difficult for new problems, like viruses, to take hold in the first place. And it's my understanding that many people who took regular enemas instead of vaccines during the 1918 pandemic made it out on the other side as well."
This is not exactly first-line advice on influenza prevention. There's no proof that a cleansing program will prevent influenza. In fact, Evans' notion contradicts basic germ theory. Influenza infection is transmitted through respiratory channels and not, like gastrointestinal infections, through contact with fecal matter. And even if people in 1918 did try to protect themselves with enemas -- Evans doesn't cite any historical record -- there's no evidence the practice saved anybody's life. Note to Evans: People did not have a choice between enemas and vaccines in 1918. The first influenza vaccine was developed in the 1940s.
The Huffington Post is one of the most valuable pieces of real estate on the Internet these days. It operates mostly as a news aggregation site (it has featured Salon stories) and throws open its doors to a wide range of bloggers, who cover everything from politics to entertainment. "When it comes to health and wellness issues, our goal is to provide a diverse forum for a reasoned discussion of issues of interest and importance to our readers," Arianna Huffington, the site's namesake founder, author, socialite and pundit, told me.
I would like to believe her. But when it comes to health and wellness, that diverse forum seems defined mostly by bloggers who are friends of Huffington or those who mirror her own advocacy of alternative medicine, described in her books and in many magazine profiles of her. Among others, the site has given a forum to Oprah Winfrey's women's health guru, Christiane Northrup, who believes women develop thyroid disease due to an inability to assert themselves; Deepak Chopra, who mashes up medicine and religion into self-help books and PBS infomercials; and countless others pitching cures that range from herbs to blood electrification to ozonated water to energy scans.
As a physician, I am not necessarily opposed to alternative health treatments. But I do want to be responsible and certain that what I prescribe to patients is safe and effective and not a waste of their time and money. A recent Associated Press
investigation stated the federal government has spent $2.5 billion of our tax dollars to determine whether alternative health remedies -- including ones promoted on the Huffington Post -- work. It found next to none of them do. The site also regularly grants space to proponents of the thoroughly disproven conspiracy that childhood vaccines have caused autism. In short, the Huffington Post is hardly a site that promotes "a reasoned discussion," in its founder's words, of health and medicine.
Practically since its inception in 2005, the Post's health coverage has been the subject of scrutiny and criticism from physicians and medical experts. Steve Novella and David Gorski, both academic physicians, who run the blog Science-Based Medicine, have been at the forefront of the opprobrium. In a post this April, Novella declared that Huffington Post readers were being "fed demonstrable medical falsehoods and misinformation."
In May, Huffington hired Patricia Fitzgerald, who had previously blogged on the site, to serve as Wellness editor. In Huffington's words, Fitzgerald will add "another layer to the vetting process for posts dealing with medical, health, and nutritional advice." Fitzgerald, an acupuncturist with a master's degree in traditional Chinese medicine and a doctorate in homeopathic medicine, is the author of "The Detox Solution: The Missing Link to Radiant Health, Abundant Energy, Ideal Weight, and Peace of Mind." Her posts had praised actress Jenny McCarthy for healing her son's autism with "biomedical intervention," a menu of "detoxification, and removal of interfering factors, such as yeast, food allergies, viruses, bacteria, and heavy metals," restrictive diets, expensive nutritional supplements and chelation therapy -- all unproven.
Fitzgerald told me her mission "is to assist in providing interesting, informative and well-written pieces that support and inspire people looking to live healthier lives." She added, "I spend a considerable amount of time helping medical professionals used to writing for other medical professionals develop a style more accessible to a general audience. Every blog post on HuffPost is reviewed by our editorial team. I vet and offer input on some posts dealing with health advice."
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Tuesday, July 28, 2009
Colchicine as medicine
In the United States colchicine by itself is not FDA approved, however it is still prescribed for the treatment of gout and also for familial Mediterranean fever, secondary amyloidosis(AA), and scleroderma. It is also used as an anti-inflammatory agent for long-term treatment of Behçet's disease.
The Australian biotechnology company Giaconda has developed a combination therapy to treat constipation-predominant irritable bowel syndrome which combines colchicine with the anti-inflammatory drug olsalazine.
Colchicine has a relatively low therapeutic index. A high therapeutic index is preferable to a low one: this corresponds to a situation in which one would have to take a much higher dose of a drug to reach the lethal threshold than the dose taken to elicit the therapeutic effect.
Long term (prophylactic) regimens of oral colchicine are absolutely contraindicated in patients with advanced renal failure (including those on dialysis). 10-20% of a colchicine dose is excreted unchanged by the kidneys. Colchicine is not removed by hemodialysis. Cumulative toxicity is a high probability in this clinical setting. A severe neuromyopathy may result. The presentation includes a progressive onset of proximal weakness, elevated creatine kinase, and sensorimotor polyneuropathy. Colchicine toxicity can be potentiated by the concomitant use of cholesterol lowering drugs (statins, fibrates). This neuromuscular condition can be irreversible (even after drug discontinuation). Accompanying dementia has been noted in advanced cases. It may culminate in hypercapnic respiratory failure and death. (Minniti-2005)
Side effects include gastro-intestinal upset and neutropenia. High doses can also damage bone marrow and lead to anemia. Note that all of these side effects can result from hyper-inhibition of mitosis.
Colchicine poisoning has been compared to arsenic poisoning: symptoms start 2 to 5 hours after the toxic dose has been ingested and include burning in the mouth and throat, fever, vomiting, diarrhea, abdominal pain and kidney failure. These symptoms may set in as many as 24 hours after the exposure. Onset of multiple-system organ failure may occur within 24 to 72 hours. This includes hypovolemic shock due to extreme vascular damage and fluid loss through the GI tract, which may result in death. Additionally, sufferers may experience kidney damage resulting in low urine output and bloody urine; low white blood cell counts (persisting for several days); anemia; muscular weakness; and respiratory failure. Recovery may begin within 6 to 8 days. There is no specific antidote for colchicine, although various treatments do exist.
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